Grx 2016 Disability Profile

MEMORANDUM | 30 August 2016
TO / Diana O’Neill, Ministry of Health
FROM / Mark Johnson and Annita Wood, Research New Zealand
SUBJECT / 2016Profile of Patients with a Disability or Impairment– Green Prescription Patient Survey (#4838)

Profile of GRx patients with a Disability or Impairment

Survey participation rate

A total of n=1313valid, completed responses were received from patients with a disability or impairment[1]during the 2016 GRx Patients survey period of July to December 2015(n=200 online, n=991 on paper and n=122by telephone).

Participation in the survey was boosted by two activities:

Reminder phone calls targeted at Māori and Pacific patients.
A prize draw incentive - three prizes of $250 gift vouchers of the winner’s choice. This was publicised in the invitation letter,on the survey questionnaire,and through the reminder calls, letters and emails.

The data that the following results have been drawn from has been weighted proportionally to the number of patients referred to the 19 different providers so that it will be representative of all 18,849eligible GRx patients referred to the initiative during the period in question.

The weighted results for the total sample in the 2016 survey have a maximum margin of error of plus or minus 1.8 percent, at the 95 percent confidence level. The maximum margin of error for the weighted results of patients with a disability or impairment is plus or minus 3.3 percent.

Reasons patients with a disability or impairment were prescribed a GRx

The most common reason why patients with a disability or impairment were prescribed a GRx wasfor weight problems (51 percent,Table 1). Other common reasons included:arthritis (33 percent), back pain or problems (31 percent), high blood pressure or risk of stroke (28 percent),stress (22 percent), depression/anxiety (21 percent), high cholesterol and/or asthma/breathing problems (both 20 percent respectively).

Patients with a disability or impairment were more likely than all GRx patients to have been referred to the GRx initiative for arthritis (33 percent compared with 22 percent overall), back pain or problems (31 percent compared to 22 percent overall), depression/anxiety (21 percent compared with 17 percent overall),asthma/breathing problems (20 percent compared with14 percent overall), injury/surgery recovery (18 percent compared with 13 percent overall), heart problems (14 percent compared with 11 percent overall) and/or fall prevention (nine percent compared with five percent overall).

Following prescribed activities

While 39percent of patients with a disability or impairmentreported they werestill following their GRx physical activities, 20 percent said they were doingphysical activity that was different from that recommended in their GRx (Table 2).The proportionsof those who mentioned they weretemporarily off GRx physical activities or who were no longer following the GRx physical activities were 21 percent and15 percent respectively.

When compared with all GRx patients, patients with a disability or impairment were more likely to be temporarily off GRx physical activities (21 percent compared with 16 percent overall).

The most frequently mentioned reason provided by patients with a disability or impairment as to why they were temporarily off or no longer following the GRx physical activitieswas because of an injury or health problems (42 percent, Table 3). Other commonly cited reasons were alack of energy/too tired(22 percent), cost (18 percent) and/or a lack of time due to family commitments (17 percent).

Compared with all GRx patients, patients with a disability or impairment were more likely to be temporarily off or no longer following their GRx physical activities because of an injury or health problems (42 percent compared with 30 percent overall).

Positive changes in health

The proportion of patients with a disability or impairment who had noticed positive changes in their health since getting their GRx (70 percent, Table 4) was far greater than those who had not noticed positive changes (16 percent).

When asked what positive changes they had noticed, patients with a disability or impairment most commonly mentioned that theygenerally felt better (52 percent), felt stronger or fitter (50 percent), had lost weight (43 percent, Table 5),had more energy (37 percent), were breathing easier (36 percent), had increased mobility (34 percent)and/or were less stressed (32 percent).

Where they had noticed changes, patients with a disability or impairmentwere more likely than all GRx patients to say theyhad increased mobility (34 percent compared with 29 percent overall).

Spending more or less time being active

Compared with the time before getting their GRx, the majority of patients with a disability or impairmentreportedspending more time being active (56 percent, Table 10),while 27percent said they were spending the same amount of timeon physical activity and13 percent were spending less time being active.

The most commonreason cited for spending about the same amount of time being active now as they were before getting their GRxwas due to illness, injury, pain or a medical condition (33 percent, Table 11). The next most common reasons mentioned werework commitments and/or a lack of motivation (both 11 percent respectively).

In terms of the reasons for being less active, the most commonly cited reason was illness, injury, an operation, pain or health problems(50 percent, Table 12).

Advice on healthy eating

Sixty-eight percent of patients with a disability or impairmentreported they had received specific advice on healthy eating(Table 13)and 68 percent have made changes to their food and/or drink intake since getting their GRx (Table 14).

The five main changes made by patients with a disability or impairmentto food and/or drink intakewere:eating less or avoiding sugar and sugary foods, sweets or soft drinks (25 percent, Table 15), eating more healthily or less junk food (22 percent), drinking more water (21 percent), eating less or smaller meals and/or eating more vegetables (both 21 percent respectively).

First contact with GRx support person

In terms of first contact, the majority of patients with a disability or impairment reported that their GRx support person contacted them first (68 percent, Table 16), while 24 percent visited their GRx support person in person, and three percent called the number provided. Four percent said they had not had any contact with the GRx support person.

Follow-up by GRx support person

In terms of follow-up support, the majority of patients with a disability or impairmentreported they hadreceived a phone call (61 percent, Table 17) and/or face-to-face support (43 percent).

GRx support people and activity providers

The four main physical activities suggested topatients with a disability or impairment by their GRx support person were: walking (65 percent,Table 19), swimming (54 percent), water or pool exercises (49 percent) and/or gym exercises (39 percent).

In terms of activity provider referrals, patients with a disability or impairment were most frequently referred to a swimming pool (72 percent, Table 20) and/or gym (55 percent) by their GRx support person.

Compared with all GRx patients,patients with a disability or impairment were more likely to have been referred to a swimming pool (72 percent compared to 66 percent overall).

Eightypercent of patients with a disability or impairmentconsidered the activity provider(s) they were referred to as appropriate, while11 percent thought it was not (Table 21).

In terms of whom patients with a disability or impairment do physical activity with, 73 percent said they do it by themselves,31 percent with adult family members, and 22 percent with friends(Table 23).

Service and support received

Ninety-one percent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘The advice I was given was helpful’(Table 24).

Eighty-fivepercent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘The physical activity options suggested were appropriate for me’(Table 25).

Eighty-three percent of patients with a disability or impairment either strongly agreed or agreedwith the statement,‘The information and advice I was given was relevant to me’(Table 26).

Eighty percent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘The person I spoke to motivated me to get or stay physically active’(Table 27).

Eighty-nine percent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘The person I spoke to was understanding and supportive’(Table 28).

Seventy-nine percent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘As a result of receiving a GRx, I now understand the benefits of physical activity’(Table 29).

Seventy-five percent of patients with a disability or impairment either strongly agreed or agreed with the statement,‘As a result of the support I got, I now feel more confident about doing physical activity regularly’ (Table 30).

Eighty-five percent of patients with a disability or impairment were either very satisfied or satisfied with the overall service provided to them (Table 31).

When patients with a disability or impairment were asked for the reasons why they were satisfiedwith the service or their GRx in general, 38 percent said they were satisfied because of the encouragement, motivation,support and/or help they had received (Table 32).

When asked for the reasons why they were less than satisfied with the service or their GRx in general,40 percent reported that the follow-up contact was insufficient or that the contact had stopped (Table 33);26 percent reported that they felt there was a lack of support and 21 percent said that more suitable ideas were required.

Patient demographics

Patients with a disability or impairment were more likely to be female than male (67 percent and 33 percent respectively, Table 34).

Twenty-nine percent of patients with a disability or impairment hada secondary schoolqualification, and 27 percent had no qualifications at all (Table 35).Forty-twopercent have tertiary qualifications or other post-secondary school qualifications.

Compared with all GRx patients, patients with a disability or impairment were more likely to have no qualification (27 percent compared with 23 percent overall).

Thirty-nine percent of patients with a disability or impairment were aged 50 to 64 years,33percent were aged 65 years or olderand 20 percent were aged 35 to 49 years (Table 37).

Compared with all GRx patients, more patients with a disability or impairment were aged50 to 64 years (39 percent compared to 34 percent overall).

Thirty-one percent of patients with a disability or impairment reported they wereretired, while 25 percent said they were either working full-time or part-time (Table 39).

Compared with all GRx patients, patients with a disability or impairment mentioned they were sickness or invalid beneficiaries (21 percent compared with 13 percent overall).

Compared with all GRx patients, morepatients with a disability or impairment said they had a Community Services Card (63 percent compared with 51 percent overall, Table 40).

Interpreting the tables in Appendix A

When interpreting the tables on the following pages, please note that bolded figures with dark shading (e.g. 37)indicate a result for patients with a disability or impairmentis significantly higher compared to the total sample. Bolded results shaded lightly (e.g. 17) indicate a result that is significantly lower.

Appendix A: 2016 survey tables

Table 1:

Q3. What were the main reasons you required a GRx for support to be more active?

Total / Disability or Impairment / No Disability or Impairment / No response
Base = / 2843 / 1313 / 1423 / 107
% / % / % / %
Arthritis / 22 / 33 / 12 / 28
Asthma/breathing problems / 14 / 20 / 9 / 22
Back pain or problems / 22 / 31 / 14 / 21
Diagnosed type 2 diabetes / 17 / 19 / 16 / 18
Pre-diabetes/risk of diabetes / 13 / 11 / 16 / 4
High blood pressure/risk of stroke / 25 / 28 / 22 / 18
High cholesterol / 18 / 20 / 17 / 15
Sleep problems / 16 / 18 / 13 / 18
To stop smoking / 5 / 4 / 5 / 8
Stress / 20 / 22 / 18 / 26
Weight problems / 53 / 51 / 56 / 42
Depression/anxiety / 17 / 21 / 14 / 14
Pregnancy / 1 / 0 / 1 / 0
Heart problems / 11 / 14 / 7 / 19
Osteoporosis / 4 / 6 / 2 / 8
Fall prevention / 5 / 9 / 2 / 8
Injury/surgery recovery / 13 / 18 / 8 / 13
General fitness / 3 / 1 / 4 / 5
Surgery recovery / 0 / 0 / 0 / 1
Mental illness / 0 / 1 / 0 / 0
Fibromyolgia / 0 / 0 / 0 / 0
Other (Specify) / 4 / 5 / 4 / 2
No response / 7 / 6 / 8 / 8